OK, I'll buy your point that for the majority of Americans, the current system works.

Let's apply that same standard to proposed conservative reforms as well: would the proposed reform make a lot of currently happy people unhappy?

For example, McCain's proposal sounded like it would more or less eliminate employer-based group coverage in favor of individually purchased plans with a standard tax credit. True, it wouldn't outlaw employer plans, but since there'd no longer be an advantage to offering them the expectation would be that many would switch out to just doing the tax credit.

Lots of Americans who are happy with the current system of group plans would be pretty screwed over by individually underwritten plans. Better for that 25yo healthy college grad than today's system, true. But it would be a catastrophe for me, a 40-something with Type II Diabetes in all four grandparent's genes, who did in fact become diabetic himself several years ago. And there would be damn few 50 year olds who wouldn't have _something_ that would make them "uninsurable" in a regular individual plan.

I know you like to suggest that the problem is limited to a few young people getting leukemia or the like, but the reality is there are millions of middle aged Americans who are currently underwritten as groups who would be screwed on their own, over totally common ailments like hypertension (let alone on family histories).

If you think we spend a lot on medicare now, just see what happens if you expand it to cover everyone who is uninsurable between ages 18-65 as well.

Or if not, what does it mean to buy insurance w/o meeting underwriting standards? I recently saw some NY state stats that put family plans in the range of $3,500 to $6,500 PER MONTH. That's right, $40,000 to $80,000 per year! What kind of annual income do you need for $50,000 a year on insurance to be "affordable"???

I'll grant that the employer based system is a kludge, but there are really only three options:

1. We do huge-group underwriting either with the current system, with a nationalized single payer pool, or the like.

2. We go individual and have massive tax subsidies to pay for the many millions of people who are "uninsurable" in that system.

3. We go individual and people who get unlucky before age 65 -- which is a LOT, not a small fraction -- get sick, don't get treated, and somtimes die.

Choose one.